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Commissioning Support Units Framework: help or hindrance?

By: Ben Gowland @ccginsider
Published: Saturday, August 16, 2014 - 13:00 GMT Jump to Comments

The new procurement framework for Commissioning Support Units (CSUs) will not allay CCG concerns over commissioning support, and may have serious negative consequences.

It has recently been announced that 16 bidders have been put forward to the Invitation to Tender (ITT) stage of the process to be part of the framework to provide end-to-end commissioning support services for CCGs.  But whatever the implications of the surrounding publicity, the reaction to this in CCG-land is, at best, muted. 

This reaction or lack of it may be a surprise.  Surely this has been carried out entirely because the CCGs wanted it?  According to the ‘Commissioning Support Lead Provider Framework Frequently Asked Questions’ document, it has been developed because:

‘Following extensive engagement last year, CCGs told us that they would like the option of a faster and simpler way of sourcing their commissioning support in a legally compliant manner rather than having to undertake a lengthy and costly OJEU procurement process themselves for their requirements.’

While this is true, it represents a binary response to the question, ‘Would you (CCGs) like to have the option of a faster and simpler way of sourcing your commissioning support in a legally compliant manner rather than having to undertake a lengthy and costly OJEU procurement process yourself?’.  Hardly surprising that CCGs responded ‘yes’.

The real question that CCGs are grappling with, however, is not which CSU they should procure services from, but whether they should buy commissioning support services from a CSU at all.  This was not a question that CCGs were asked as part of the ‘extensive engagement’. The recent development in North West London, where the 8 CCGs decided to bring commissioning support services in house, is just one recent example of the output of these conversations.

CCGs also want to understand how they can use their CSU better, how they can form stronger and more effective partnerships with their CSU, and how they and their CSU can develop together to improve overall effectiveness.  They want to understand the level of client-side expertise they need to be effective, the level of in-house CSU management resource that is required, and how best to share information meaningfully across the two organisations.

But none of these are questions that the lead provider framework addresses.  What the framework does is enable CCGs to run a competitive process between CSUs.  Now, as CSUs each have geographical areas, it is hard to see how this is going to work.  But according to the NHS England website, ‘CSUs are not geographically defined’.  It is somewhat surprising, then, to find that CSUs all have geographically based names (North East London CSU, Cheshire and Merseyside CSU, Greater Manchester CSU etc.).  How realistic is it that if I was based in Portsmouth that my commissioning support would be provided by Yorkshire and Humber CSU? So how much change are we expecting?

There is also a risk that the process will destabilise some of the CSUs that have managed to survive this far.  If enough CCGs across an existing geographical area choose a different provider won’t the current CSU, despite being on the framework, stop being viable?  The answer appears to lie in the following excerpt from the FAQ document,

‘Of course CCGs can use the Framework whenever they are ready to, however, we want to minimise the financial risk on the system as a result of fragmentation, ensure CCGs are not left without the support they need (where their neighbours procure early), and ensure that the system as a whole gets the best and most cost effective response from providers through bringing some of their requirements together.’

This implies that pressure will be put on CCGs to carry out joint procurements so that changes can be made ‘en masse’.  But however this plays out, it seems to me that the framework is unlikely to result in any significant change. It will halt, at least temporarily, any progress that is currently being made in CSU/CCG relationships, it will at best divert CSU attention at a time when support for CCG delivery is at its most critical and at worst destabilise more CSUs, and it may well result in a significant reversion to in-house provision by CCGs at a time when out sourced support is on the cusp of being able to demonstrate its value.

The views and opinions expressed in this article are those of the author(s) and do not necessarily reflect the official policy or position of The Information Daily, its parent company or any associated businesses.

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